I am in need of the collective wisdom of Lactnet for a mother I am working
with.  Her husband persuaded her to breastfeed, she agreed to try and is now
absolutely hooked despite six weeks of painful breasts and nipples and other
problems. A very motivated woman - well informed, empowered and oodles of
common sense.

First baby, 6 weeks old, normal, unmedicated birth.  At 2 weeks mother had
uterine infection and was very ill.  My first contact with her was 2 days
ago. Salient points:  Baby breastfeeds on cue, 1 to 3 hourly - both breasts.
Has been given a few bottles of EBM and occasionally uses pacifier.  Nipples
have been sore since first feeds in hospital (very pink and pinched when
baby comes off the breast.)  Breasts extremely lumpy and painful between
feeds.  Areolar soft.  Leaking +++. Painful and very forceful MER.  Baby
softens breasts effectively and quickly.  Symmetrical latch, tongue behind
gumline.  Deeper, asymmetrical latch attempted, but baby would not open
mouth.  Suggested avoidance of artificial teats, cobathing,  feeding baby
before too alert, one breast per feed.

Second contact:  Breasts less engorged.  Baby opened mouth wide (mother been
working on this), few deep, asymmetrical latches achieved, but after one or
two sucks, baby adjusted back to more shallow attachment.  Oral anatomy
normal, tongue comes forward in charm hold.  Finger feeding attempted, but
baby not interested.  Mother tried later and reported that tongue came
forward over gumline when milk was introduced.

Question:  Is baby's latch the result of trying to protect his airway from
OALD?  How do we correct it?

Many thanks.

Jean Ridler  RN  RM  IBCLC   Cape Town

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